Donor-derived infections-Insights from Singapore, Japan, and Thailand.

IF 2.6 4区医学 Q3 IMMUNOLOGY Transplant Infectious Disease Pub Date : 2024-11-01 Epub Date: 2024-09-03 DOI:10.1111/tid.14370

Sophie Seine Xuan Tan, Pakpoom Phoompoung, Koh Okamoto, Methee Chayakulkeeree, Xiu Xian Koh, Chee-Kiat Tan, Sally Nyuk Min Kong, Thuan Tong Tan, Shimin Jasmine Chung, Ban Hock Tan

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Abstract

Background: Solid organ transplantation (SOT) has expanded significantly in Asia over past few decades. Donor-derived infections (DDIs) remain a significant concern as they may adversely impact transplant outcomes. We aim to review the existing regulatory frameworks, screening protocols, and management practices for DDIs in Asia.

Methods: We reached out to transplant infectious diseases experts in Asia to provide standardized data on annual SOT numbers, incidence of DDIs, regulatory frameworks, donor and recipient screening protocols, and DDI surveillance measures. We present the data from Singapore, Japan, and Thailand.

Results: Donor screening for HIV, hepatitis B, hepatitis C, and syphilis is mandatory in all countries. Additionally, Japan screens for HTLV-1 antibody due to its endemicity. We also reviewed the protocols for screening and prevention of endemic infections in Asia. Singapore is the only country implementing universal screening for all donors for dengue, Zika, and chikungunya via blood and urine RT-PCR. Strongyloidiasis screening is not routinely done, although some transplant centers empirically give ivermectin prophylaxis to organ recipients. Tuberculosis screening with a donor questionnaire and chest radiograph is common for deceased donors, and some centers do Interferon Gamma Release Assay test for living donors. We also found a significant gap in the surveillance and reporting of potential DDIs in Asia and the overall incidence of DDIs in Asia is unknown and likely underreported.

Conclusion: The experiences of Singapore, Japan, and Thailand offer valuable insights into current practices and the unmet needs regarding a DDI registry and call for coordinated efforts to address this critical issue in the region.

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来自新加坡、日本和泰国的捐献者衍生感染。

背景：过去几十年来，亚洲的实体器官移植（SOT）得到了显著发展。供体源性感染（DDIs）可能会对移植结果产生不利影响，因此仍然是一个值得关注的重大问题。我们旨在回顾亚洲现有的 DDIs 监管框架、筛查方案和管理实践：方法：我们联系了亚洲的移植传染病专家，请他们提供有关年度 SOT 数量、DDI 发生率、监管框架、供体和受体筛查方案以及 DDI 监控措施的标准化数据。我们展示了来自新加坡、日本和泰国的数据：结果：所有国家都强制要求对捐献者进行艾滋病毒、乙型肝炎、丙型肝炎和梅毒筛查。此外，由于 HTLV-1 是地方性流行病，日本还对 HTLV-1 抗体进行筛查。我们还审查了亚洲地方性感染的筛查和预防方案。新加坡是唯一一个通过血液和尿液 RT-PCR 对所有捐献者进行登革热、寨卡病毒和基孔肯雅病毒普遍筛查的国家。虽然一些器官移植中心会根据经验对器官受捐者进行伊维菌素预防，但并不常规进行丝虫病筛查。通过捐赠者问卷和胸片对已故捐赠者进行肺结核筛查很常见，一些中心还对活体捐赠者进行干扰素γ释放检测。我们还发现，亚洲在监测和报告潜在的 DDIs 方面存在很大差距，亚洲 DDIs 的总体发生率尚不清楚，而且很可能报告不足：新加坡、日本和泰国的经验为 DDI 登记方面的现行做法和未满足的需求提供了宝贵的见解，并呼吁该地区协调努力解决这一关键问题。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplant Infectious Disease 医学-传染病学

CiteScore

5.30

自引率

7.70%

发文量

210

审稿时长

4-8 weeks

期刊介绍： Transplant Infectious Disease has been established as a forum for presenting the most current information on the prevention and treatment of infection complicating organ and bone marrow transplantation. The point of view of the journal is that infection and allograft rejection (or graft-versus-host disease) are closely intertwined, and that advances in one area will have immediate consequences on the other. The interaction of the transplant recipient with potential microbial invaders, the impact of immunosuppressive strategies on this interaction, and the effects of cytokines, growth factors, and chemokines liberated during the course of infections, rejection, or graft-versus-host disease are central to the interests and mission of this journal. Transplant Infectious Disease is aimed at disseminating the latest information relevant to the infectious disease complications of transplantation to clinicians and scientists involved in bone marrow, kidney, liver, heart, lung, intestinal, and pancreatic transplantation. The infectious disease consequences and concerns regarding innovative transplant strategies, from novel immunosuppressive agents to xenotransplantation, are very much a concern of this journal. In addition, this journal feels a particular responsibility to inform primary care practitioners in the community, who increasingly are sharing the responsibility for the care of these patients, of the special considerations regarding the prevention and treatment of infection in transplant recipients. As exemplified by the international editorial board, articles are sought throughout the world that address both general issues and those of a more restricted geographic import.